| NPI | 1669485694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 17917) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY 17917) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IN 32579) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |