| NPI | 1679612907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A75140) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NC 2009-01670) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2023-12-14 |