| NPI | 1104015387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A112298) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: CA A112298) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2019-07-09 |