| NPI | 1164400115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX D 0936) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX D 0936) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AR R 4660) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: LA MD.03696R) | |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2016-09-08 |