| NPI | 1215311915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: CA A137384) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 137384) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: CA A13384) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2025-09-12 |