| NPI | 1063706992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX MD93025) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: TX MD93025) |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2024-09-25 |