NPI | 1104970540 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A110375) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 060344) |
2086S0105X Surgery Surgery of the Hand (Licence: CA A110375) | |
Enumeration Date | 2007-01-23 |
Last Update Date | 2024-09-13 |