| NPI | 1871574715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: ME 018741) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TN TN38369) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: TN TN 38369) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TN TN 38369) | |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2011-04-06 |