| NPI | 1942595871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: MS 27565) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OK 32928) |
| 208600000X Surgery (Licence: SC 33806) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2023-08-09 |