| NPI | 1861697815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60529146) |
| Additional Taxonomies | 208600000X Surgery (Licence: AR E-14521) |
| 208600000X Surgery (Licence: TX 390200000X) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AR E-14521) | |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2024-06-04 |