| NPI | 1770694069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA g69368) |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: CA g69368) |
| 208200000X Plastic Surgery (Licence: CA g69368) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-03-20 |