| NPI | 1023305018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD460847) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: UT 10742767-1205) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: UT 10742767-1205) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: UT 10742767-1205) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2021-11-29 |