| NPI | 1619217049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME128990) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL TRN13072) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 74226) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD454829) | |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2016-08-22 |