| NPI | 1053387902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX F1893) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TX F1893) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX F1893) | |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2023-10-13 |