| NPI | 1982787594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MD D54936) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: VA 0101840367) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: DC MD32010) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2007-07-08 |