| NPI | 1164463733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301111414) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NY 2213601) |
| 204F00000X Transplant Surgery (Licence: MI 4301111414) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-01-08 |