| NPI | 1245210723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301042946) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301042946) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2012-04-25 |