| NPI | 1043213069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: LA MD.201997) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME0080667) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2012-01-26 |