| NPI | 1447741806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IA MD-51511) |
| Additional Taxonomies | 208600000X Surgery (Licence: IA R-11140) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2023-07-03 |