| NPI | 1851350227 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0129X (Licence: TX E9498) | 
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX E9498) | 
| Enumeration Date | 2006-03-22 | 
| Last Update Date | 2009-02-05 |