| NPI | 1487639449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: CT 54296) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: AZ 26494) |
| 208600000X Surgery (Licence: AZ 26494) | |
| 208600000X Surgery (Licence: CT 54296) | |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2014-02-18 |