NPI | 1215370432 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: GA 76039) |
Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: GA 76039) |
2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A160974) | |
Enumeration Date | 2013-04-08 |
Last Update Date | 2020-09-17 |