| NPI | 1023337631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: ID M14785) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: ID M14785) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2019-12-10 |