| NPI | 1982851028 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: RI MD20381)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2012-01848)  | 
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD465533)  | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D71376)  | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD 248501)  | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301500845)  | |
| Enumeration Date | 2008-08-20 | 
| Last Update Date | 2025-02-04 |