| NPI | 1396899373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: KY 33550) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: KY 33550) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: KY 33550) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: KY 33550) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: KY 33550) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2014-02-04 |