| NPI | 1629556337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: CA A196126) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: FL ME182486) |
| Enumeration Date | 2018-08-03 |
| Last Update Date | 2026-08-03 |