| NPI | 1083740757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 43584) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L217524) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO 2008014395) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2016-04-06 |