| NPI | 1003866781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MA 223128) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 223128) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2013-04-01 |