| NPI | 1164867438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: CO DR.0076958) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: OH 35.149039) |
| 208600000X Surgery (Licence: OH 35.149039) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2026-09-01 |