| NPI | 1619242047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX F6158) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX F6158) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2015-04-29 |