| NPI | 1225136286 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 01839) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2007-01839) |
| 2086S0129X Surgery Vascular Surgery (Licence: NC 01839) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 01839) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2014-11-18 |