| NPI | 1437121340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CO 43479) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 232028) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 46245) | |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2007-07-09 |