| NPI | 1861888794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 20A20785) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: CA 20A20785) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2025-09-25 |