| NPI | 1922200062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OH 35.140978) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NY 285512) |
| 207Q00000X Family Medicine (Licence: OK 30485) | |
| 208600000X Surgery (Licence: RI LP01072) | |
| 208600000X Surgery (Licence: NY 285512) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2022-10-13 |