| NPI | 1790070969 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0129X (Licence: CA 198963) | 
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA 198963) | 
| Enumeration Date | 2011-06-15 | 
| Last Update Date | 2024-12-18 |