| NPI | 1770753170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: NY 284705) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MD D67378) |
| 204F00000X Transplant Surgery (Licence: CT 82758) | |
| 208600000X Surgery (Licence: NY 284705) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2026-05-05 |