| NPI | 1295714327 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 9600439) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NC 9600439) |
| 208600000X Surgery (Licence: NC 9600439) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2011-08-12 |