| NPI | 1952360307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME105261) |
| Additional Taxonomies | 208600000X Surgery (Licence: CT 043891) |
| 2086S0102X Surgery Surgical Critical Care (Licence: CT 043891) | |
| 208600000X Surgery (Licence: IA 36943) | |
| 204F00000X Transplant Surgery (Licence: IA 36943) | |
| 2086S0102X Surgery Surgical Critical Care (Licence: IA 36943) | |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2013-06-07 |