NPI | 1811347511 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA 20A22729) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS021193) |
Enumeration Date | 2016-06-14 |
Last Update Date | 2024-08-08 |