| NPI | 1326061961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: TX P1031) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: LA 015826R) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2017-04-05 |