| NPI | 1972703015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101249419) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX N1191) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX FTL 41883) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: SC 27000) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX N1191) | |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2012-12-10 |