| NPI | 1861947996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 209800000X Legal Medicine (Licence: FL ME17550) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME17550) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: FL ME17550) | |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |