| NPI | 1508815002 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: FL ME141696) | 
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: AL 35090) | 
| 204F00000X Transplant Surgery (Licence: IN 01054551A) | |
| Enumeration Date | 2006-05-10 | 
| Last Update Date | 2019-09-23 |