| NPI | 1699859462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 45908) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX E5356) |
| 207P00000X Emergency Medicine (Licence: TX E5356) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-06-15 |