| NPI | 1992779128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: SC 32973) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KY 37044) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: SC 32973) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2010-07-19 |