| NPI | 1497168595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: SC 91003) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: WV 29682) |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2023-10-19 |