| NPI | 1376806356 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA 1376806356) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 53517) |
| 207R00000X Internal Medicine (Licence: MA 253299) | |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2025-11-12 |