| NPI | 1730569633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: NY 293587) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: VA 0116027734) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2018-05-02 |