| NPI | 1992903082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 41018) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: PA MD424154) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD424154) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2010-01-21 |