| NPI | 1831139906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: NC 35274) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: VA 0101047263) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-09-28 |