| NPI | 1609891035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OR MD15245) |
| Additional Taxonomies | 2086S0105X Surgery Surgery of the Hand (Licence: OR MD15245) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2014-10-13 |