| NPI | 1972599587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME96463) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: GA 050474) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2022-03-21 |