| NPI | 1649333410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 19012) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: NC 19012) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2014-02-21 |