| NPI | 1972679256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OR MD153414) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MD d0057608) |
| 208600000X Surgery (Licence: WA MD00048641) | |
| 204F00000X Transplant Surgery (Licence: WA MD00048641) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2013-04-12 |