| NPI | 1184786758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G072819) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA G072819) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA G072819) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-07-08 |