| NPI | 1679680441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: WA MD60000969) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: WA MD60000969) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2023-11-14 |