| NPI | 1114987682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OR MD20970) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR MD20970) |
| 2086S0129X Surgery Vascular Surgery (Licence: OR MD20970) | |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2010-11-18 |