| NPI | 1396951620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MS 24649) |
| Additional Taxonomies | 208600000X Surgery (Licence: MS 24649) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MS 24649) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2022-11-29 |