| NPI | 1851504336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2019-01249) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: NE 6796) |
| 208600000X Surgery (Licence: VA 0101242359) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-09-10 |