| 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 |