| NPI | 1790743573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A41242) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A41242) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2014-12-01 |