| NPI | 1528047875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX J9650) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX J9650) |
| 208600000X Surgery (Licence: TX J9650) | |
| 208200000X Plastic Surgery (Licence: TX J9650) | |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2016-02-29 |