| NPI | 1710908132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: OH 35-094445) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: TX L1448) |
| 208600000X Surgery (Licence: TX L1448) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2021-01-08 |