| NPI | 1932526407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DC MD040993) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101259677) |
| 208D00000X General Practice (Licence: VA 0101259677) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: DC MD040993) | |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2023-07-26 |