| NPI | 1356879134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD61534520) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 271800) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2025-01-21 |