| NPI | 1083948384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 267143) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: PA MD438146) |
| 208600000X Surgery (Licence: NC 2016-00513) | |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2022-07-21 |