NPI | 1548608524 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD60955940) |
Additional Taxonomies | 208600000X Surgery (Licence: WA MD60955940) |
Enumeration Date | 2013-06-12 |
Last Update Date | 2024-03-29 |