NPI | 1366696072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NM MD2017-0533) |
Additional Taxonomies | 208600000X Surgery (Licence: NM MD2017-0533) |
Enumeration Date | 2008-11-07 |
Last Update Date | 2018-05-16 |