| NPI | 1407811854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: OH 35.088914) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A107087) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2014-01-24 |