| NPI | 1750439782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A95380) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A95380) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: CA A95380) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2019-12-30 |