| NPI | 1356548242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX N0450) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: NY 239007-1) |
| 208200000X Plastic Surgery (Licence: TX N0450) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 239007-1) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TX N0450) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2013-12-19 |