| NPI | 1700998259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A31051) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CA A31051) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A31051) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2010-09-21 |