NPI | 1255794798 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD D0100530) |
Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: MA 1013171) |
2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: MA 1013171) | |
Enumeration Date | 2016-04-01 |
Last Update Date | 2024-10-15 |