| NPI | 1417991993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MA 224398) |
| Additional Taxonomies | 2086S0120X Surgery Pediatric Surgery (Licence: MA 224398) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2006-01140) | |
| 2086S0120X Surgery Pediatric Surgery (Licence: NC 2006-01140) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD417984) | |
| 2086S0120X Surgery Pediatric Surgery (Licence: PA MD417984) | |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2010-05-28 |