| NPI | 1114307030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301107634) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: WI 77117) |
| 208600000X Surgery (Licence: WI 77117) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301107634) | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2024-09-05 |