| NPI | 1366978678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 022658) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 022658) |
| Enumeration Date | 2017-05-05 |
| Last Update Date | 2017-05-05 |