| NPI | 1396836268 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OR MD169191) | 
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101240637) | 
| 208600000X Surgery (Licence: VA 0101240637) | |
| Enumeration Date | 2006-09-27 | 
| Last Update Date | 2016-03-28 |