| NPI | 1871738831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: TX N1552) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX N1552) |
| 208200000X Plastic Surgery (Licence: FL ME169780) | |
| 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: TX N1552) | |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: TX N1552) | |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2025-01-20 |