| NPI | 1386639664 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D75512)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: MD D75512)  | 
| Enumeration Date | 2005-09-13 | 
| Last Update Date | 2013-08-28 |