| NPI | 1487636080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: MA 150300) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA 150300) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MA 150300) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |