| NPI | 1669538997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A100549) |
| Additional Taxonomies | 208600000X Surgery (Licence: KY TP950) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2019-12-18 |