| NPI | 1538143235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: CO 31474) |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: CO 31474) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2015-08-04 |