NPI | 1982645461 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL me66793) |
Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: FL ME66793) |
Enumeration Date | 2006-06-08 |
Last Update Date | 2011-08-26 |