| NPI | 1508083817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: NY 270200) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-221349) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2017-04-25 |