NPI | 1144664970 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX U3891) |
Additional Taxonomies | 208600000X Surgery (Licence: OK 29829) |
Enumeration Date | 2013-04-23 |
Last Update Date | 2023-08-01 |