| NPI | 1720087919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 277097) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: CT 041519) |
| 204F00000X Transplant Surgery (Licence: RI MD12241) | |
| 208600000X Surgery (Licence: CT 041519) | |
| 208600000X Surgery (Licence: RI MD12241) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2019-06-28 |