| NPI | 1679885172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: FL TRN# 15531) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL TRN# 15531) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL TRN# 15531) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |