| NPI | 1215926597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35069832) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: OH 35069832) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2015-02-12 |