| NPI | 1235376377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NV 13044) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA A104346) |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2014-02-20 |