| NPI | 1164758264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: AZ 53996) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 53996) |
| 208600000X Surgery (Licence: CA 110117) | |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2022-07-21 |