| NPI | 1467455022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX H3341) |
| Additional Taxonomies | 2086S0129X (Licence: TX H3341) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: TX H3341) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2011-01-31 |