| NPI | 1255390738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: LA 201121) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 45923-020) |
| 208600000X Surgery (Licence: NY 221244-1) | |
| 208C00000X Colon & Rectal Surgery (Licence: WI 45923-020) | |
| 208C00000X Colon & Rectal Surgery (Licence: NY 221244-1) | |
| 208600000X Surgery (Licence: LA 201121) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2013-03-14 |