| NPI | 1821626631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KS 94-11665) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA ML61073004) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2025-07-31 |