| NPI | 1376572289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD159594) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: OR MD159594) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OR MD159594) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2015-06-05 |