| NPI | 1902878564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 94070) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MA 238207) |
| 208600000X Surgery (Licence: MA 238207) | |
| 208600000X Surgery (Licence: FL ME166014) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2025-05-21 |