| NPI | 1598755811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 062083) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX F3628) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2010-12-29 |