| NPI | 1972035194 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: PA MD485917) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2017-03-28 | 
| Last Update Date | 2024-09-06 |