| NPI | 1255324869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: WV 09496) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: WV 09496) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: WV 09496) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2011-07-18 |