| NPI | 1245503788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MI 4301505425) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: FL ME135627) |
| 204F00000X Transplant Surgery (Licence: SC AL37466) | |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2022-06-06 |