| NPI | 1902830433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MD D0052487) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: MD D0052487) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D0052487) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2008-02-29 |