| NPI | 1326097932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CA A126269) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: MO 2024010340) |
| 2086S0127X Surgery Trauma Surgery (Licence: IN 01079722A) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2024-03-22 |