| NPI | 1053342683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D54596) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D0054596) |
| 208600000X Surgery (Licence: MD D54596) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-09-19 |