| NPI | 1033292149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: TX J2175) |
| Additional Taxonomies | 2086S0105X Surgery Surgery of the Hand (Licence: TX J2175) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2025-04-16 |