| NPI | 1972535128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: WA MD60106891) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G79098) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2015-10-15 |