| NPI | 1851525919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: VA 0101258189) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: MD D81081) |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: DC MD043991) | |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2025-09-04 |