| NPI | 1902890999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME154293) |
| Additional Taxonomies | 2086S0129X (Licence: IN 01057522A) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2025-11-17 |