| NPI | 1437190501 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA G059181) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G059181) |
| 208200000X Plastic Surgery (Licence: CA G059181) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2015-09-14 |