| NPI | 1871020313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: CO CDRH.0072339) |
| Additional Taxonomies | 208600000X Surgery (Licence: CO CDRH.0072339) |
| 208600000X Surgery (Licence: MN 71493) | |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2025-08-07 |