| NPI | 1508020074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: TX Q5420) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: TN 50735) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2021-08-20 |