| NPI | 1508116914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301106555) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA MD445621) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: PA MD445621) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: PA MD445621) | |
| 208200000X Plastic Surgery (Licence: NV 14794) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: MI 4301106555) | |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2016-06-08 |