| NPI | 1194725762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 080790) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA 208600000X) |
| 208600000X Surgery (Licence: MO 2009014868) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2009-01579) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO 2009014868) | |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2018-12-19 |