NPI | 1730341074 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 244867) |
Additional Taxonomies | 208600000X Surgery (Licence: NY 244867) |
Enumeration Date | 2008-06-27 |
Last Update Date | 2022-05-18 |