| NPI | 1699920652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A106052) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A106052) |
| 204F00000X Transplant Surgery (Licence: CA A106052) | |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2022-07-22 |