NPI | 1770782443 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PR 18303) |
Additional Taxonomies | 208600000X Surgery (Licence: PR 18303) |
208600000X Surgery (Licence: SC 34566) | |
Enumeration Date | 2007-07-13 |
Last Update Date | 2016-06-09 |