| NPI | 1558300681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G86010) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: CA G86010) |
| 2086S0127X Surgery Trauma Surgery (Licence: CA G86010) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA G86010) | |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2010-03-19 |