| NPI | 1932146248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX J8787) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX J8787) |
| 2086S0105X Surgery, Surgery of the Hand (Licence: TX J8787) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX J8787) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2007-07-09 |