| NPI | 1093820243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA a83387) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME74858) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2024-04-15 |