| NPI | 1285052860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: UT 13870036-1205) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: UT 13870036-1205) |
| 208600000X Surgery (Licence: CA a141274) | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-04-11 |