| NPI | 1720472368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: TN 57735) |
| Additional Taxonomies | 208600000X Surgery (Licence: TN 000057735) |
| Enumeration Date | 2015-03-21 |
| Last Update Date | 2025-07-24 |