| NPI | 1790797421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101253349) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: FL ME54586) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME54586) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2022-02-10 |