| NPI | 1760484398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D0062685) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MD D62685) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2024-07-01 |