| NPI | 1982767711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00045148) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00045148) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2022-04-04 |