| NPI | 1669964391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: MI 4301503207) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35.140351) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2023-05-02 |