NPI | 1245493733 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35131402) |
Additional Taxonomies | 208600000X Surgery (Licence: MO 2008015647) |
208600000X Surgery (Licence: MO 2010017357) | |
Enumeration Date | 2008-07-06 |
Last Update Date | 2018-10-23 |