| NPI | 1518300656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: GA 74469) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: WI 72757) |
| 208600000X Surgery (Licence: WI 72757) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2022-08-23 |