| NPI | 1992891881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A60390) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA a60390) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2014-02-20 |