| NPI | 1184111015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OK 33927) |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 33927) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2026-08-04 |