| NPI | 1497863773 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD60608427) | 
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A66563) | 
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101248648) | |
| Enumeration Date | 2006-08-28 | 
| Last Update Date | 2015-12-21 |