| NPI | 1679558837 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL OS8006) | 
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL OS8006) | 
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: FL OS8006) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: FL OS8006) | |
| Enumeration Date | 2005-12-09 | 
| Last Update Date | 2021-01-26 |