| NPI | 1609172097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AR T2026-068) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2018-01729) |
| 204F00000X Transplant Surgery (Licence: CA A146226) | |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2026-04-28 |