| NPI | 1740603018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NC 2014-00071) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 99-7946-99) |
| 208600000X Surgery (Licence: NC 2014-00071) | |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2014-05-08 |