| NPI | 1295971430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: FL ME124430) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: CA A125791) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2021-06-08 |