| NPI | 1366677007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: WI 65960-20) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: WI 65960-20) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2021-01-25 |