| NPI | 1154344307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OR MD27350) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00023765) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA 23765) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-04-21 |