NPI | 1043202450 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00019557) |
Additional Taxonomies | 2086S0129X (Licence: WA MD00019557) |
Enumeration Date | 2005-08-22 |
Last Update Date | 2025-09-11 |