| NPI | 1306124367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 270456) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NY 270456) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2013-10-10 |