| NPI | 1528273422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101252358) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301080425) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD442820) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2012-11-14 |