| NPI | 1215433008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61411862) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: WA MD61411862) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2023-09-29 |