| NPI | 1427204098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WA MD60865626) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MT191401) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: PA MT191401) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: PA MT191401) | |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2021-11-08 |