| NPI | 1124010509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OR MD08494) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00020667) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO R3034) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA G15870) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MT 6808) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2007-07-09 |