| NPI | 1841404951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A107214) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: CA A107214) |
| 208600000X Surgery (Licence: WV 23871) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2021-11-29 |