| NPI | 1992708515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NM 2002-0074) |
| Additional Taxonomies | 2086S0129X (Licence: NM 2002-0074) |
| 208600000X Surgery (Licence: MD D0062526) | |
| 208600000X Surgery (Licence: VA 0101241098) | |
| 208600000X Surgery (Licence: NM 2002-0074) | |
| 2086S0129X (Licence: MD D0062526) | |
| 2086S0129X (Licence: VA 0101241098) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MD D0062526) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: NM 2002-0074) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: VA 0101241098) | |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2017-01-12 |