| NPI | 1588848428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA 60329943) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: WA 60329943) |
| 208600000X Surgery (Licence: MT 43357) | |
| 2086X0206X Surgery Surgical Oncology (Licence: WA 60329943) | |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2021-06-18 |