| NPI | 1346282928 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 65673) | 
| Additional Taxonomies | 208600000X Surgery (Licence: GA 65673) | 
| 208600000X Surgery (Licence: NM 2003-0489) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NM 2003-0489) | |
| Enumeration Date | 2006-06-11 | 
| Last Update Date | 2020-08-10 |