| NPI | 1679546402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME126152) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: FL ME126152) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MN 44541) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WI 44200-020) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2022-07-21 |