| NPI | 1962469015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F3388) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: TX F3388) |
| 208600000X Surgery (Licence: TX F3388) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2024-05-03 |