| NPI | 1457432601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 062833) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC ll25628) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL Trn13669) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME111956) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 062833) | |
| 208D00000X General Practice (Licence: GA 062833) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-10-07 |