| NPI | 1780615559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101240870) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD D63281) |
| 208600000X Surgery (Licence: VA 0101240870) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2014-12-08 |