| NPI | 1649245606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: PA MD422144) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: VA 0101256380) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-10-15 |