| NPI | 1902946965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: LA 13465R) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 13465R) |
| 208600000X Surgery (Licence: LA 13465R) | |
| 2086S0120X Surgery Pediatric Surgery (Licence: TX U1489) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX U1489) | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2023-01-18 |