| NPI | 1114955028 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: VA 0101262112) | 
| Additional Taxonomies | 208600000X Surgery (Licence: IL 113000041) | 
| Enumeration Date | 2006-06-29 | 
| Last Update Date | 2017-04-21 |