| NPI | 1669472080 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208600000X Surgery (Licence: NY 219980) | 
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NY 219980) | 
| Enumeration Date | 2005-07-28 | 
| Last Update Date | 2025-04-29 |