| NPI | 1679950109 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: MA 271136) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MA L-262339) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2026-09-04 |