| NPI | 1598848699 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NH 15454) | 
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NH 15454) | 
| 208200000X Plastic Surgery (Licence: MA 232740) | |
| Enumeration Date | 2006-10-23 | 
| Last Update Date | 2012-01-06 |