| NPI | 1063499820 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 40957) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: MN 40957) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2011-12-29 |