| NPI | 1578941969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: NY 316570) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301107048) |
| 208600000X Surgery (Licence: NY 316570-01) | |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2024-05-02 |