NPI | 1528455441 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD481259) |
Additional Taxonomies | 208600000X Surgery (Licence: PA MD481259) |
Enumeration Date | 2015-04-17 |
Last Update Date | 2024-03-22 |