| NPI | 1376514778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301097526) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD067016L) |
| 208600000X Surgery (Licence: MI 4301097526) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2018-07-09 |