| NPI | 1851779052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: UT 14158197-1235) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 135974) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: IL 036166547) | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2024-10-10 |