| NPI | 1578820015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX W1398) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: OH 35.133496) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2026-01-07 |