| NPI | 1194746602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AR E-6357) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-6357) |
| 208200000X Plastic Surgery (Licence: AR E6357) | |
| 208600000X Surgery (Licence: MS 17264) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-11-23 |