| NPI | 1710062427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO MDR8767) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: KS 0415055) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: MO MDR8767) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: KS 0415055) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: MO MDR8767) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: KS 0415055) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2009-02-04 |