| NPI | 1407144686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: CT 80475) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: WI 60765-20) |
| Enumeration Date | 2011-07-21 |
| Last Update Date | 2025-05-28 |