| NPI | 1568435592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD027758E) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD027758E) |
| 2086X0206X Surgery, Surgical Oncology (Licence: PA MD027758E) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-10-06 |