| NPI | 1780660746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60562819) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NH 6905) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD60562819) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-02-11 |