| NPI | 1376626523 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: AZ 71467) | 
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2003-00961) | 
| 208600000X Surgery (Licence: CA A060649) | |
| 204F00000X Transplant Surgery (Licence: TX M8627) | |
| Enumeration Date | 2006-10-23 | 
| Last Update Date | 2024-01-03 |