| NPI | 1205989191 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX FTL# 43047) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: TX FTL# 43047) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2015-03-26 |