| NPI | 1629117247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CO 32365) |
| Additional Taxonomies | 174400000X Specialist (Licence: CO 32365) |
| 208200000X Plastic Surgery (Licence: CO 32365) | |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: CO 32365) | |
| 2086S0105X Surgery Surgery of the Hand (Licence: CO 32365) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2016-07-18 |