| NPI | 1467493510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 124) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA 32076) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IA 32076) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-01-06 |