2025-03112
Active
Yes
08/29/2025
08/01/2027
See: Actions-Adverse & Administrative Tab
Active Supervisees
| Name | Type | Status | Approved | Inactive |
| None Reported |
North Carolina Hospital Admitting Privileges
Out of State Active/Inactive Licenses
Out of Country Active/Inactive Licenses
Address
Chapel Hill, NC
Information
Medical School
| School | Graduation |
| Nagoya City University | 2010 |
Post Graduate Training
"Last Year" does not necessarily mean that the licensee completed his/her training program. (In NC, a physician can be licensed without completing such a program.)
| Institution | Specialty | State, Country | Training Program | Last Year |
| Nagoya City University West Medical Center | General Surgery |
Japan
| Fellowship | 2017 |
| Tosei General Hospital | General Surgery |
Japan
| Residency | 2012 |
Current Board Certification and Year of Certification/Recertification
Physicians should not list non-ABMS or non-AOA specialty boards unless the board meets the criteria set forth in the NC Medical Board’s Advertising and Publicity Position Statement.
| Primary/Subspecialty | Year |
| None Reported |
Area of Practice
| Area Of Practice | Primary |
| Abdominal Surgery | Yes |
Current Membership in Medical Professional Organizations
Honors & Awards
| Honor/Award | Given By | Date |
| None Reported |
Public Service
| Name of Clinic | Service Description | Date |
| None Reported |
Current Academic Appointments
| Title | Institution | City, State, Country |
| None Reported |
Publications
Section 1: Adverse Actions
North Carolina Medical Board Public Actions
| Date | Description | Link |
| None Reported |
Other Regulatory Board or Agency Public Actions
| Date | Name of Board/Agency | Action Taken | Link |
| None Reported |
Health Care Institution Suspensions and Revocations
| Date | Health Care Institution | Action Taken |
| None Reported |
Section 2: Administrative Actions
Actions listed in this section are considered non-disciplinary by the Board. In situations where
administrative actions are taken, the licensee may not have met certain statutory requirements or
may have failed to follow correct administrative procedures.
North Carolina Medical Board Reentry Agreement
| Date | Description | Link |
| None Reported |
North Carolina Special Purpose Licensing Agreement
The Special Purpose License is for physicians who wish to come to North Carolina for a limited time, scope
and purpose, such as to demonstrate, train or learn a new technique, procedure or piece of equipment, or to
educate physicians or medical students.
| Date | Description | Link |
|
08/28/2025
| Special Purpose License Agreement |
View
|
Malpractice Information
The Board is currently reviewing the care that led to this payment.
| Incident Date | Payment Date | Area of Practice | City, State, Country | Response |
| None Reported |
Misdemeanor/DUI/DWI Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |
Felony Conviction Information
| Conviction Date | Conviction | Jurisdiction | Sentence |
| None Reported |