| NPI | 1982676110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery (Licence: MI 4301089405) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NJ 2086S0122X) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2022-03-02 |