| NPI | 1114325123 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA F346) | 
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: CA F346) | 
| 2086X0206X Surgery, Surgical Oncology (Licence: CA F346) | |
| Enumeration Date | 2014-12-08 | 
| Last Update Date | 2015-03-30 |