| NPI | 1992801005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: AZ 4885) |
| Additional Taxonomies | 2086S0129X (Licence: AZ 372-18) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2019-01-14 |