| NPI | 1629087663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0129X (Licence: TX C8691) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX C8691) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2015-07-23 |