| NPI | 1528271384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: PR 13636) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MI 1463942) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-06-19 |