| NPI | 1760777056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: GA 96612) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: WI 69436) |
| 208600000X Surgery (Licence: WI 69436) | |
| 208600000X Surgery (Licence: GA 96612) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2023-09-12 |