| NPI | 1962853994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: OK 38745) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: OH 57.028162) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2023-08-03 |