NPI | 1053486977 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX N6213) |
Additional Taxonomies | 208600000X Surgery (Licence: CA A91039) |
Enumeration Date | 2006-11-24 |
Last Update Date | 2025-07-08 |