| NPI | 1548259310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35047874) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: OH 35047874) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OH 35 047874) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2022-10-27 |