| NPI | 1053592055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60847093) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: PA MD 432986) |
| 208600000X Surgery (Licence: ND 13552) | |
| 208600000X Surgery (Licence: IN 01076355A) | |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2020-08-04 |