| NPI | 1669698247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: UT 8237507-1205) |
| Additional Taxonomies | 208600000X Surgery (Licence: NH RT 1664) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2021-11-02 |