| NPI | 1700763877 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA LT001072) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: PA LT001072) |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-09-17 |