| NPI | 1578970976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MA 258659) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 291006) |
| 208600000X Surgery (Licence: ZZ 1561) | |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2017-09-05 |