| NPI | 1144285297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 18708) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: KY 18708) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2019-06-28 |