| NPI | 1023019676 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: IA 33677)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: IA 33677)  | 
| Enumeration Date | 2005-08-04 | 
| Last Update Date | 2007-12-11 |