| NPI | 1649367772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TN MD30162) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: TN MD30162) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2022-03-29 |