| NPI | 1083640825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WY TL8537) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MA 238379) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2025-01-02 |