| NPI | 1629502133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 307670) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NY 307670) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 307670) | |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2025-07-26 |