| NPI | 1235680653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301505333) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NE 7859) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2024-02-06 |