| NPI | 1366519266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: FL ME128087) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA g81070) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2018-08-20 |