| NPI | 1841250156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AL 24023) |
| Additional Taxonomies | 174400000X Specialist (Licence: AL 24023) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2011-12-21 |