| NPI | 1316471634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME177113) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A180785) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AZ 75701) | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2026-03-24 |