| NPI | 1679917025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: AZ 60516) |
| Additional Taxonomies | 2086S0105X Surgery Surgery of the Hand (Licence: AZ 60516) |
| Enumeration Date | 2013-04-27 |
| Last Update Date | 2021-04-09 |