| NPI | 1639286495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: CA 00AS18240) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 00AS18240) |
| 2086S0129X Surgery Vascular Surgery (Licence: CA 00AS18240) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2019-09-25 |