| NPI | 1316910037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MA 56651) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 44107) |
| 208600000X Surgery (Licence: MA 56651) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2019-02-11 |