| NPI | 1609877539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: WI 35264) |
| Additional Taxonomies | 208D00000X General Practice (Licence: WI 35264) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2022-11-02 |