| NPI | 1306848098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OR MD17068) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00029081) |
| 208600000X Surgery (Licence: OR MD17068) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2021-06-04 |