| NPI | 1225215734 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: PA MT194254) | 
| Additional Taxonomies | 208600000X Surgery (Licence: CT AY26291556135) | 
| Enumeration Date | 2008-01-28 | 
| Last Update Date | 2015-07-23 |