| NPI | 1609066455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: MI 4301095684) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: DE C1-0027939) |
| 208600000X Surgery (Licence: DE C1-0027939) | |
| 208600000X Surgery (Licence: MI 4301095684) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2025-04-21 |