| NPI | 1184687469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CO 41762) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CO 41762) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CO 41762) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2008-06-18 |