| NPI | 1043509813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX S5596) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: TX S5596) |
| 208200000X Plastic Surgery (Licence: MA 266725) | |
| 208200000X Plastic Surgery (Licence: CA A122852) | |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2026-06-04 |