| NPI | 1003960626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: CT 61502) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MN 59802) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2018-08-02 |