| NPI | 1326288473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MA 240704) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 232159) |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2017-06-12 |