| NPI | 1073545554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MS 17806) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MS 17806) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2020-12-30 |