| NPI | 1619021698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX P8958) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: TX P8958) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TX P8958) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2019-06-14 |