NPI | 1578558557 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL ME92891) |
Additional Taxonomies | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: FL ME92891) |
2082S0105X Plastic Surgery Surgery of the Hand (Licence: FL ME92891) | |
Enumeration Date | 2005-09-15 |
Last Update Date | 2010-08-20 |