| NPI | 1841519782 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: WI 65752) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: PA 208200000X) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: WI 65752) | |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2021-01-27 |