| NPI | 1235146028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: KY 26468) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: KY 26468) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2015-05-12 |