| NPI | 1891747697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2012037425) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2012037425) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO 2012037425) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2018-01-24 |