| NPI | 1558414227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A142656) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CT 54159) |
| 208600000X Surgery (Licence: CT 54159) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: CA A142656) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: RI MD15715) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: CT 54159) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2018-12-26 |