| NPI | 1871612515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: TN 44645) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TN 44645) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TN 44645) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 44645) | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2024-03-15 |