| NPI | 1184728537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: NE 20963) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NE 20963) |
| 208200000X Plastic Surgery (Licence: WY 6212A) | |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: WY 6212A) | |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: NE 20963) | |
| 208600000X Surgery (Licence: WY 6212A) | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: WY 6212A) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-02-18 |