| NPI | 1902861867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME133012) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: KY 37082) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2020-08-31 |