| NPI | 1114006574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WV 22938) |
| Additional Taxonomies | 208600000X Surgery (Licence: AL 22607) |
| 208600000X Surgery (Licence: WA MD00044597) | |
| 208600000X Surgery (Licence: NY 212308) | |
| 208600000X Surgery (Licence: WV 22938) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2021-04-21 |