| NPI | 1932373073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX m8534) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: LA 025605) |
| 207P00000X Emergency Medicine (Licence: TX m8534) | |
| 208600000X Surgery (Licence: LA 025605) | |
| 208600000X Surgery (Licence: TX m8534) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: LA 025605) | |
| Enumeration Date | 2008-04-19 |
| Last Update Date | 2022-05-18 |