| NPI | 1497747943 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: CA NA) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA G740930) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA 6218) | |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2010-07-19 |