| NPI | 1831168269 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME149825) | 
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101231181) | 
| 208600000X Surgery (Licence: VA 0101231181) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101231181) | |
| Enumeration Date | 2006-03-17 | 
| Last Update Date | 2021-08-24 |