| NPI | 1043315542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OK 35451) |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TX F2138) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: OK 35451) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX F2138) | |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-01-27 |