| NPI | 1356326813 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: AZ 27972) | 
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: FL ME131450) | 
| 204F00000X Transplant Surgery (Licence: MN 41512) | |
| Enumeration Date | 2005-12-07 | 
| Last Update Date | 2020-09-03 |