| NPI | 1700071974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA G43327) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN Temp) |
| 208600000X Surgery (Licence: FL ME98058) | |
| 208600000X Surgery (Licence: CA G43327) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME98058) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2019-12-20 |