| NPI | 1043708860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A166277) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA 166277) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2025-07-09 |