| NPI | 1861534828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX H1515) |
| Additional Taxonomies | 2086S0129X (Licence: TX H1515) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2015-03-19 |