| NPI | 1528105897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WI 55219020) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: WI 55219020) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: WI 55219020) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2014-01-10 |