| NPI | 1427039189 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: WA MD60931749) | 
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD60931749) | 
| Enumeration Date | 2005-11-09 | 
| Last Update Date | 2019-07-01 |