| NPI | 1003858515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NM 97-397) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NM 97--397) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2012-04-23 |