| NPI | 1427129709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD431885) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 49774) |
| 208600000X Surgery (Licence: MO 2001011446) | |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2017-02-03 |