| NPI | 1962424390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X (Licence: PA MD032109L) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: PA MD032109L) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2011-10-20 |