| NPI | 1316047582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 19007) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO R3H78) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: SC 27660) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX L2787) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2017-11-20 |