| NPI | 1770124273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: OH 35.148632) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 57.248605) |
| Enumeration Date | 2019-10-05 |
| Last Update Date | 2023-08-18 |