| NPI | 1891703112 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME116089) | 
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: OH 35.092626) | 
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: IL 036-115517) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: FL ME116089) | |
| Enumeration Date | 2006-08-03 | 
| Last Update Date | 2020-04-15 |