| NPI | 1114960770 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME108817) |
| Additional Taxonomies | 208600000X Surgery (Licence: MT 8074) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: ND 11659) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2015-02-16 |