| NPI | 1942313671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202K00000X (Licence: NV 11758) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: NV 11758) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NV 11758) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-09-18 |