| NPI | 1477512051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: OR 40854) |
| Additional Taxonomies | 208600000X Surgery (Licence: OR 40854) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OR 40854) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2011-03-04 |