| NPI | 1811164619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 34.010008) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 58.001935) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2021-12-22 |