| NPI | 1558725572 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA A152842) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA A152842) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2024-08-23 |