| NPI | 1386640670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: KY 27559) |
| Additional Taxonomies | 208C00000X Colon & Rectal Surgery (Licence: KY 27559) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 27559) | |
| 208D00000X General Practice (Licence: KY 27559) | |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2008-08-13 |