| NPI | 1932190980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO 2002023140) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G85299) |
| 208600000X Surgery (Licence: WI 34541-020) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2018-03-29 |