| NPI | 1194102467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD490370) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: PA MD490370) |
| 208600000X Surgery (Licence: PA MD490370) | |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2025-07-08 |