| NPI | 1821527524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA OP61586554) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: CA 20A19589) |
| 204F00000X Transplant Surgery (Licence: WA OP61586554) | |
| 208600000X Surgery (Licence: IA R-10926) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2024-08-30 |