Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 48676 | MA |
NPI | 1124217385 |
---|---|
Provider Name | Christopher R Shackleton |
First Address | Vancouver, BC V6J3V2 |
Second Address | Vancouver, BC V6J3V2 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 23/10/2007 |