| NPI | 1932557303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: KY 57136) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: RI LP03702) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2024-03-11 |