| NPI | 1609066455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: MI 4301095684) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301095684) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2016-02-02 |