| NPI | 1710977632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 056148) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: GA 056148) |
| Enumeration Date | 2005-10-22 |
| Last Update Date | 2012-10-31 |