| NPI | 1780979476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MN 70490) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 299259) |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2022-01-10 |