| NPI | 1619199098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: OH 35.095758) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: OH 35.095758) |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: OH 35.095758) | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IL 125-046333) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-07-23 |