| NPI | 1376507731 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: LA MD.023731) | 
| Additional Taxonomies | 208600000X Surgery (Licence: LA MD.023731) | 
| Enumeration Date | 2006-04-13 | 
| Last Update Date | 2019-03-06 |