NPI | 1962464222 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: OR md25711) |
Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: OR md25711) |
2082S0105X Plastic Surgery, Surgery of the Hand (Licence: OR md25711) | |
Enumeration Date | 2006-04-03 |
Last Update Date | 2019-12-11 |