| NPI | 1023640687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: VA 0101275850) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57.248303) |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2023-08-08 |