| NPI | 1124468079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WV 31536) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA FD4039132) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2023-01-18 |