| NPI | 1275519332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NM MD2011-0499) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 36052) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MN 46968) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-02-04 |