| NPI | 1053300145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MA 57198) |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: MA 57198) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2011-09-29 |