| NPI | 1518273986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: TX R5193) |
| Additional Taxonomies | 208600000X Surgery (Licence: MD not known) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2019-12-16 |