| NPI | 1457385817 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35065137P) | 
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35065137P) | 
| 208600000X Surgery (Licence: KY 29550) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 29550) | |
| Enumeration Date | 2006-07-10 | 
| Last Update Date | 2014-03-25 |