| NPI | 1346744554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OK 41048) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A174018) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2023-06-23 |