| NPI | 1215967732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OH 35054145) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: OH 35054145) |
| 208200000X Plastic Surgery (Licence: NY 264243) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2012-04-04 |