| NPI | 1265401566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 44393) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA66089) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2016-06-01 |