| NPI | 1720006810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: HI 17065) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: GA 056250) |
| 204F00000X Transplant Surgery (Licence: VT 042-0011342) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-06-11 |