| NPI | 1215903372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME118912) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD422307) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2016-03-17 |