| NPI | 1346388600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 20A7647) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA 20A7647) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2022-07-21 |