| NPI | 1235197088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301108566) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: MI 4301108566) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2023-05-09 |