| NPI | 1104984400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD031132E) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: PA MD031132E) |
| 208200000X Plastic Surgery (Licence: PA MD031132E) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: PA MD031132E) | |
| 208600000X Surgery (Licence: PA MD031132E) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: PA MD031132E) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2023-03-07 |