| NPI | 1134395254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: OH 35099637) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208600000X Surgery (Licence: OH 35099637) | |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2018-03-12 |