| NPI | 1194985119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MT 26713) |
| Additional Taxonomies | 208600000X Surgery (Licence: MT 26713) |
| 208600000X Surgery (Licence: OK 26473) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2022-10-04 |