| NPI | 1467671701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: UT 9750730-1205) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: UT 9750730-1205) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-11-01 |