| NPI | 1912904806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA A43203) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A43203) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2015-06-10 |