| NPI | 1124387907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: CT 83631) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 308337) |
| 204F00000X Transplant Surgery (Licence: NY 308337) | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2026-03-12 |