| NPI | 1285827337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME108922) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME108922) |
| 208600000X Surgery (Licence: GA 70812) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 70812) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2022-02-01 |