| NPI | 1760542054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: UT 9580790-1205) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: FL 10757) |
| 208600000X Surgery (Licence: FL ME108537) | |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2016-06-29 |