| NPI | 1902884299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME82789) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: IA 31448) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: FL ME82789) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2012-07-05 |