| NPI | 1871525865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 20437) |
| Additional Taxonomies | 208600000X Surgery (Licence: IN 01046063) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2015-06-18 |