| NPI | 1699805911 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: MD D0075219) | 
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: TX R8570) | 
| 208600000X Surgery (Licence: TX R8570) | |
| Enumeration Date | 2007-03-06 | 
| Last Update Date | 2019-08-21 |