| NPI | 1164455333 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2017-00517) | 
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2017-00517) | 
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: SC 37609) | |
| Enumeration Date | 2006-07-09 | 
| Last Update Date | 2019-02-05 |