NPI | 1669401881 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A96118) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: VA 0101232282) |
2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: DC MD036077) | |
Enumeration Date | 2006-07-01 |
Last Update Date | 2023-08-29 |