| NPI | 1326054073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OH 35.085868) |
| Additional Taxonomies | 208600000X Surgery (Licence: OH 35-08-5868) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2019-10-04 |