| NPI | 1063875367 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.150347)  | 
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME159388)  | 
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: FL ME159388)  | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: OH 35.150347)  | |
| Enumeration Date | 2016-04-04 | 
| Last Update Date | 2024-04-03 |