| NPI | 1164541397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: GA 67241) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301085631) |
| 204F00000X Transplant Surgery (Licence: KS 04-37124) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2014-04-13 |