| NPI | 1992112460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 204F00000X Transplant Surgery (Licence: AL 44392) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: IL 125.073497) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2023-01-20 |