| NPI | 1811183015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 89944) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R71779) |
| 204F00000X Transplant Surgery (Licence: NY 59296) | |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2021-08-17 |