| NPI | 1548577596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: OH 35120704) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35120704) |
| 208600000X Surgery (Licence: PA MD454338) | |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2024-08-21 |