| NPI | 1154643039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME125112) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301095817) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WV 24662) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.090281) | |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2016-09-30 |