| NPI | 1174767495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TX Q4574) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX Q4574) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: TX Q4574) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2026-02-02 |