| NPI | 1417307653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.132795) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35.132795) |
| 208200000X Plastic Surgery (Licence: OH 57.028312) | |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2023-05-02 |