| NPI | 1649385451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: SD 8457) |
| Additional Taxonomies | 2086S0129X (Licence: NE 18180) |
| 2086S0129X (Licence: IA 27908) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2012-08-16 |