| NPI | 1467459040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KS 0440775) |
| Additional Taxonomies | 2086S0129X (Licence: MI 4301074648) |
| 2086S0129X (Licence: OH 65938) | |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2018-04-30 |