| NPI | 1841491883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD418508) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD418508) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2025-09-11 |