| NPI | 1770577504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: FL ME 78250) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME 78250) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2016-03-03 |