| NPI | 1104811066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WV 10951) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: WV 10951) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: OH 35047379) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OH 3504379) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2010-08-19 |