| NPI | 1992894075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WA MD61025436) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: WA MD61025436) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-11-05 |