| NPI | 1720232895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CO 53530) |
| Additional Taxonomies | 208600000X Surgery (Licence: UT 7154787-1205) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: UT 7154787-1205) | |
| Enumeration Date | 2008-11-15 |
| Last Update Date | 2014-07-21 |