| NPI | 1114035995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD443747) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: ME 016864) |
| 2086S0105X Surgery, Surgery of the Hand (Licence: ME 016864) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2025-04-04 |