| NPI | 1801940200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 061305) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: GA 061305) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2016-04-04 |