| NPI | 1437719317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX T4729) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: TX T4729) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2022-10-05 |