| NPI | 1356699631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: OH 35.145293) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301100822) |
| 208600000X Surgery (Licence: OH 57.251737) | |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2023-08-09 |