| NPI | 1699765859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 80823) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MA 80823) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2007-07-08 |