| NPI | 1144249491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 68000) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: FL ME91422) |
| 208600000X Surgery (Licence: FL ME91422) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2012-10-29 |