| NPI | 1790746790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NV 24505) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NJ 25MA10202300) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD068831L) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.122143) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2025-03-18 |