| NPI | 1023261575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: TX P9941) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: AZ 45990) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2024-06-03 |