Modality *:
Physical AttendanceOnline Attendance

First Name *:

Last Name *:

National ID *:

E-mail *:

Phone *:

Street address *:

Postcode / ZIP *:

Town / City *:

Country *:

Province *:

Principal area of expertise *:
Adult Cardiac Surgeon staffCardiac Surgery residentAnesthesiologist specialized in Cardiac Surgery or Transcatheter proceduresCardiologist (either staff or resident)

Additional information:
Include a little comment of your expertise

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