NPI | 1235253253 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NV 13989) |
Additional Taxonomies | 208600000X Surgery (Licence: NV 13989) |
Enumeration Date | 2007-03-16 |
Last Update Date | 2023-03-07 |