| NPI | 1093959231 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: WI 56155-20) | 
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: FL ME145251) | 
| Enumeration Date | 2009-04-30 | 
| Last Update Date | 2021-02-17 |