| NPI | 1093070294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: TX R8050) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: WI 66021-20) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2019-05-02 |