| NPI | 1043553761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CO DR.0067587) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TN 50270) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2022-03-18 |