| NPI | 1407030950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: KY 55958) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: IA rr7990) |
| 208600000X Surgery (Licence: IA 40787) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: KY TP202) | |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2021-09-17 |