| NPI | 1346464930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX N5336) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX N5336) |
| 208600000X Surgery (Licence: TX N5336) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2021-02-23 |