| NPI | 1962601120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: SD 7527) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: CA 20A9986) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2020-01-28 |