| NPI | 1861653255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A110607) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: AZ 49308) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: AZ 49308) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: AZ 49308) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: AZ 49308) | |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2022-11-03 |