| NPI | 1528404993 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA A185081)  | 
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT204058)  | 
| 2086S0105X Surgery, Surgery of the Hand (Licence: KY 56141)  | |
| Enumeration Date | 2013-05-13 | 
| Last Update Date | 2024-09-06 |