| NPI | 1295753762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN MD0000011485) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TN MD0000011485) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MS 17134) | |
| 208D00000X General Practice (Licence: MS 17134) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-01-29 |