NPI | 1902980410 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX D7249) |
Additional Taxonomies | 208600000X Surgery (Licence: TX D7249) |
2086S0120X Surgery, Pediatric Surgery (Licence: TX D7249) | |
Enumeration Date | 2006-10-24 |
Last Update Date | 2013-09-06 |