| NPI | 1265953004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: OH 57.029182) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NY 306448) |
| Enumeration Date | 2017-07-01 |
| Last Update Date | 2023-07-03 |