| NPI | 1215174560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A48391) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA A48391) |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2013-01-15 |