| NPI | 1124078662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 35305) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: WI 35305) |
| 2086S0129X Surgery, Vascular Surgery (Licence: WI 35305) | |
| 208C00000X Colon & Rectal Surgery (Licence: WI 35305) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 35305) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2008-05-08 |