| NPI | 1154457547 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NH 16950) | 
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-221064) | 
| 208600000X Surgery (Licence: NH 16950) | |
| Enumeration Date | 2007-02-27 | 
| Last Update Date | 2015-02-13 |