| NPI | 1376700757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD60281878) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 49735-20) |
| 208600000X Surgery (Licence: WA MD60281878) | |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2012-07-20 |