| NPI | 1972792117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TN 53310) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57.013910) |
| 208600000X Surgery (Licence: TX P2667) | |
| 208600000X Surgery (Licence: MN 106876) | |
| 208600000X Surgery (Licence: MN 106883) | |
| 208600000X Surgery (Licence: MN 56911) | |
| 204F00000X Transplant Surgery (Licence: TN 53310) | |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2015-11-24 |