| NPI | 1285635672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: CA C52961) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD037728E) |
| 204F00000X Transplant Surgery (Licence: PA MD-037728-E) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2012-03-02 |