| NPI | 1578879300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: KY 43614) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: KY 43614) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2022-06-08 |