| NPI | 1992703151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD00029853) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WA MD00029853) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2007-11-14 |