| NPI | 1831316181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A83369) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301088189) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301088189) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2012-02-29 |