NPI | 1831190040 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: WA MD00015888) |
Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00015888) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2011-11-10 |