| NPI | 1679676621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 271998) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: CT 80236) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2025-03-06 |