| NPI | 1417484759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: KY TP191) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: OH 57.254077) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX BP10060964) | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2024-05-15 |