| NPI | 1215466131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A201451) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MA 286133) |
| 208200000X Plastic Surgery (Licence: TX U9278) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA A201451) | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2025-08-04 |