| NPI | 1811962327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: MA 159960) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: OH 35.099739) |
| Enumeration Date | 2006-02-18 |
| Last Update Date | 2025-10-28 |