| NPI | 1518171347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME129801) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD 22084) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD453199) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2017-03-17 |