| NPI | 1639263098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MI 5101015176) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MI 5101015176) |
| 2086S0127X Surgery, Trauma Surgery (Licence: MI 5101015176) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2021-04-06 |