| NPI | 1083665574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO 113503) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MO 113503) |
| 208600000X Surgery (Licence: PA MD428212) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2021-03-23 |