| NPI | 1770515215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: NY 302040) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MA 227921) |
| 204F00000X Transplant Surgery (Licence: RI MD14437) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-01-29 |