| NPI | 1154329092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IA 26531) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: IA 26531) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2013-09-17 |