| NPI | 1629085196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CO 44716) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: CO 44716) |
| 208200000X Plastic Surgery (Licence: CO 44716) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CO 44716) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CO 44716) | |
| 208600000X Surgery (Licence: CO 44716) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2016-03-29 |