| NPI | 1558361139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A48591) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: TX H5264) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2010-10-29 |