| NPI | 1366460339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: MO 2006020250) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: MO 2006020250) |
| 2086S0120X Surgery, Pediatric Surgery (Licence: MO 2006020250) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MO 2006020250) | |
| 2086S0127X Surgery, Trauma Surgery (Licence: MO 2006020250) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2015-10-28 |