| NPI | 1821031899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CT 024179) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CT 024179) |
| 2086S0105X Surgery, Surgery of the Hand (Licence: CT 024179) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2009-12-04 |