| NPI | 1790136158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 85558-20) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301504731) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301504731) | |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2025-06-26 |