| NPI | 1922098375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AZ 13540) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: AZ 13540) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2011-10-31 |