| NPI | 1093734717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: VA 0101233860) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MD D0066278) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: DC MD0334485) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2009-02-19 |