| NPI | 1053317149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TN 26589) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TN 26589) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2022-04-14 |