| NPI | 1841586484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX R8086) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT200150) |
| 208600000X Surgery (Licence: FL TRN23219) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2018-10-29 |