| NPI | 1215966809 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CA G39324) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: CA G39324) |
| 208200000X Plastic Surgery (Licence: CA G39324) | |
| 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: CA G39324) | |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: CA G39324) | |
| 208600000X Surgery (Licence: CA G39324) | |
| 2086S0105X Surgery Surgery of the Hand (Licence: CA G39324) | |
| 2086S0127X Surgery Trauma Surgery (Licence: CA G39324) | |
| 2086S0120X Surgery Pediatric Surgery (Licence: CA G39324) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2010-09-28 |