| NPI | 1932228871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX S6435) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MI 4301085870) |
| 208600000X Surgery (Licence: MI 4301085870) | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: MI 4301085870) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2022-01-12 |