| NPI | 1376962654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: MA 290502) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60939550) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2021-12-29 |