| NPI | 1245338623 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX N9720) | 
| Additional Taxonomies | 208600000X Surgery (Licence: CA G87155) | 
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA G87155) | |
| Enumeration Date | 2006-09-20 | 
| Last Update Date | 2011-07-12 |