| NPI | 1174506869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 057474) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 057474) |
| 2086S0129X Surgery, Vascular Surgery (Licence: GA 057474) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2020-12-03 |