| NPI | 1861548455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00048009) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00048009) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: WA MD00048009) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2017-02-07 |