| NPI | 1548623622 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: TX V7805) | 
| Additional Taxonomies | 208600000X Surgery (Licence: TX V7805) | 
| Enumeration Date | 2016-04-05 | 
| Last Update Date | 2025-08-14 |