| NPI | 1699737494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 41559) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2005-01855) |
| 208600000X Surgery (Licence: NC 2005-01855) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NC 2005-01855) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2013-03-01 |