| NPI | 1013934843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD450096) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: VT 0420010978) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2017-03-21 |