| NPI | 1255628517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MS 23081) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: MS 23081) |
| 208200000X Plastic Surgery (Licence: MS 23081) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2026-01-01 |