| NPI | 1215391982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: WA MD.MD.70127399) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD.MD.70127399) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2026-08-28 |