| NPI | 1144831975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IA MD-50841) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: IA MD-50841) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: KY FT607) | |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2025-08-22 |