| NPI | 1639503386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: WA MD61165377) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A133182) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2022-01-17 |