| NPI | 1811094576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: CA G076581) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G076581) |
| 2086S0105X Surgery Surgery of the Hand (Licence: CA G076581) | |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2014-01-27 |