| NPI | 1851372072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35-063360) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: OH 35-063360) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2015-03-24 |