| NPI | 1518145051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MN 52479) |
| Additional Taxonomies | 208600000X Surgery (Licence: MN 52479) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MN 52479) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WI 65902) | |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2021-07-02 |