| NPI | 1013302603 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: TN 69057) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61148921) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2023-10-26 |