| NPI | 1629209366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MN 63088) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM RS2009-0378) |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2018-08-30 |