| NPI | 1306864483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD031335E) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2011-01426) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2011-01426) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-05-29 |