| NPI | 1912167792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NY 113650) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 113650) |
| 208600000X Surgery (Licence: CA A26368) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A26368) | |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2008-06-14 |