| NPI | 1699799023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CA A91704) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A91704) |
| 2086S0105X Surgery Surgery of the Hand (Licence: CA A91704) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2016-09-08 |