| NPI | 1992143382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 55713) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX BP10047956) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2021-09-30 |