| NPI | 1225419823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: TN 0000065625) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD 8779) |
| 208600000X Surgery (Licence: IL 036.151178) | |
| 208600000X Surgery (Licence: TN 0000065625) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2022-09-23 |