| NPI | 1730167404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CT 64282) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MA 225173) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD437562) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2019-09-27 |