| NPI | 1568444305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MO 2017001968) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AL 25672) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 282282) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MS 23405) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 87355) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2023-06-12 |