| NPI | 1447368758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: ID M-5527) |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: ID M-5527) |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2015-02-20 |