| NPI | 1376980896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MA10898700) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: IL 036.145129) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2024-03-04 |