| NPI | 1962452664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00038070) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MD00038070) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2021-03-31 |