| NPI | 1407831233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX N5031) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX N5031) |
| 207V00000X Obstetrics & Gynecology (Licence: TX N5031) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2026-06-19 |