| NPI | 1376754879 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX P6975) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10022131) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: UT 7963276-1205) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2013-09-30 |