| NPI | 1942225388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA A71492) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA A71492) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2016-02-16 |