| NPI | 1164441275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: KY 30632) |
| Additional Taxonomies | 2086S0105X Surgery Surgery of the Hand (Licence: KY 30632) |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: KY 30632) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2010-11-24 |