| NPI | 1043296676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX H9766) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX H9766) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2018-03-17 |