| NPI | 1780778035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: OH 35071275) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 9901500) |
| 208600000X Surgery (Licence: FL ME113599) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-03-01 |