| NPI | 1538471503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD60722820) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 63893-20) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2021-01-18 |