| NPI | 1871581090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CO 25951) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: CO 25951) |
| 2086S0129X Surgery, Vascular Surgery (Licence: WY 3933A) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WY 3933A) | |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2016-03-22 |