| NPI | 1316093347 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX H6266) | 
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: TX H6266) | 
| Enumeration Date | 2007-01-25 | 
| Last Update Date | 2008-01-31 |