| NPI | 1457404279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CO 51423) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D0064899) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA FE60148989) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2013-06-10 |