| NPI | 1174582423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WV 17911) |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: WV 17911) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2021-11-17 |