| NPI | 1356382295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA C55426) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA MD203285) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2017-12-19 |