| NPI | 1043308844 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX L0223) | 
| Additional Taxonomies | 174400000X Specialist (Licence: TX L0223) | 
| Enumeration Date | 2006-10-10 | 
| Last Update Date | 2012-02-29 |