Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 34094 | AZ |
N | 208200000X | Surgeon | 34094 | AZ |
N | 208600000X | Surgeon | 34094 | AZ |
NPI | 1609962489 |
---|---|
Provider Name | Ernesto P Molmenti |
First Address | Tucson, AZ 85704-5822 |
Second Address | Tucson, AZ 85724-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
938699 | (05) | AZ |
G81261 | (02) |