| NPI | 1619266111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A122755) |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: CA A122755) |
| 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery (Licence: CA A122755) | |
| 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: CA A122755) | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2020-03-12 |