| NPI | 1225200637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A77473) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: CA A77473) |
| 208200000X Plastic Surgery (Licence: CA A77473) | |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2020-11-10 |