| NPI | 1083615934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TN 54798) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 33217) |
| 208600000X Surgery (Licence: PA MD448565) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2016-10-03 |