| NPI | 1558627612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: MO 2019045769) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: PA MD460429) |
| 208600000X Surgery (Licence: NY 273146) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2020-02-03 |