| NPI | 1295863520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: OR 23806) |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: OR 23806) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2024-06-27 |