| NPI | 1780611855 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: AZ 48852) | 
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MN 60341) | 
| 204F00000X Transplant Surgery (Licence: MD D64207) | |
| Enumeration Date | 2006-06-26 | 
| Last Update Date | 2020-09-08 |