| NPI | 1215920236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OR MD14793) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00033156) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA G68679) | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2007-07-09 |