| NPI | 1639135890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: NY 263532) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 263532) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2012-05-16 |