| NPI | 1841432960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME132641) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD 8917) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2022-07-21 |