| NPI | 1295275261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TX D3798) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX D3798) |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2017-02-24 |