| NPI | 1346352812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00040041) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 102400) |
| 208600000X Surgery (Licence: WA MD00040041) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-06-24 |