| NPI | 1568509099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: MS 17284) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 17284) |
| 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: MS 17284) | |
| 208600000X Surgery (Licence: MS 17284) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MS 17284) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2011-01-19 |