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 |