| NPI | 1811101538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: SC 81933) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: AL 28464) |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2019-01-15 |