| NPI | 1487691051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA G44719) |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery (Licence: CA G44719) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2007-08-08 |