| NPI | 1013914241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301056980) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: MI 4301056980) |
| 174400000X Specialist (Licence: MI 4301056980) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2017-01-31 |