| NPI | 1821097619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 69447) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD441270) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: ND 10170) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2018-06-18 |