| NPI | 1003822206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 38148) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NC 9300144) |
| 207Q00000X Family Medicine (Licence: NC 9300144) | |
| 208600000X Surgery (Licence: NC 9300144) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2024-06-18 |