| NPI | 1578760633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: DC MD043461) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MI 4301087280) |
| 208600000X Surgery (Licence: WI 53113) | |
| 208600000X Surgery (Licence: MD D0080121) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2018-06-11 |