| NPI | 1336380088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CO 0056095) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX P 0692) |
| 208600000X Surgery (Licence: OH 35-123216) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35-123216) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX P 0692) | |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2016-02-05 |