| NPI | 1427058130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME114887) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 95-00541) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 95-00541) | |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: FL ME 114887) | |
| 208600000X Surgery (Licence: FL ME14887) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2022-05-16 |