| NPI | 1497818017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301047302) |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: MI 4301047302) |
| 208600000X Surgery (Licence: MI 4301047302) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2007-07-08 |