| NPI | 1538279609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: UT 1788168905) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: UT 1788161205) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-11-10 |