| NPI | 1699005322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AZ 49766) |
| Additional Taxonomies | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: AZ 49766) |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: AZ 49766) | |
| 2086S0105X Surgery Surgery of the Hand (Licence: AZ 49766) | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: AZ 49766) | |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2019-12-09 |