| NPI | 1194015693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: UT 10668647-1205) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: UT 10668647-1205) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2023-05-12 |