| NPI | 1689637183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CO 31688) |
| Additional Taxonomies | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: CO 31688) |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: CO 31688) | |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2008-04-14 |