| NPI | 1538216296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: WA MD00041866) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: WA MD00041886) |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: WA MD00041886) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2022-05-03 |