| NPI | 1629023221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: WI 60859) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IN 01041790A) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2016-11-08 |