| NPI | 1487661724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TX G7380) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX G7380) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TX G7380) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2009-11-02 |