| NPI | 1487641098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME108379) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD070770-L) |
| 208600000X Surgery (Licence: OH 35082482V) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35082482V) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD070770-L) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2018-09-10 |