| NPI | 1053513473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A83768) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CA A83768) |
| 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine (Licence: CA A83768) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2024-04-29 |