| NPI | 1316486897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 34493) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NE 7874) |
| Enumeration Date | 2017-02-17 |
| Last Update Date | 2022-08-09 |