| NPI | 1417154329 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MN 49945) | 
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: MN 49945) | 
| Enumeration Date | 2007-07-03 | 
| Last Update Date | 2020-08-12 |