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 |