| NPI | 1215322649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301502622) |
| Additional Taxonomies | 208600000X Surgery |
| 204F00000X Transplant Surgery (Licence: VA 0101275321) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2023-06-19 |