| NPI | 1205805603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101222198) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101222198) |
| 208600000X Surgery (Licence: VA 0101222198) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2007-12-06 |