| NPI | 1922219815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: LA MD.205050) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301080563) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD434336) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2012-10-12 |