| NPI | 1740494467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CO 22517) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: CO 22517) |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MI 34139) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CO 22517) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: MI 34139) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: MI 34139) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2014-07-22 |