| NPI | 1457514226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX V1764) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 003034) |
| 208200000X Plastic Surgery (Licence: NY 003034) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: NY 003034) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: NY 003034) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2024-12-01 |