| NPI | 1477992949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD60842674) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: WA MD60842674) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2021-03-30 |