NPI | 1841957396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NM PA2023-0238) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-11-19 |
Last Update Date | 2023-08-07 |