| NPI | 1356432553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX R1549) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AR E-4664) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: AR E-4664) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2010-01391) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2017-06-12 |