| NPI | 1902050180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: WV 25070) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV 25070) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2015-11-23 |