| NPI | 1699118174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: NM MD2021-0736) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 65599) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2021-07-20 |