| NPI | 1407094998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: NJ 25MA08894600) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: PA MT192744) |
| Enumeration Date | 2009-01-22 |
| Last Update Date | 2020-10-19 |