| NPI | 1376839449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA a124914) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: GA 77814) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2019-07-24 |