NPI | 1366400129 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IA MD-45927) |
Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 056120) |
2086S0120X Surgery Pediatric Surgery (Licence: IA MD-45927) | |
Enumeration Date | 2006-05-02 |
Last Update Date | 2019-07-08 |