| NPI | 1790994960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IA 39026) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R7471) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2013-10-14 |