| NPI | 1013400860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: AZ 80001) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD61547137) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2026-08-19 |