| NPI | 1417150228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX Q70773) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX Q7073) |
| 208600000X Surgery (Licence: TX Q7073) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2022-04-06 |