| NPI | 1154579605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 52084) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2008023487) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TN 54552) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY TP975) | |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2019-03-08 |