| NPI | 1205389996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: LA 322034) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NC 241174) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2023-10-17 |