| NPI | 1255794798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD D0100530) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery Hand Surgery (Licence: MA 1013171) |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: MA 1013171) | |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-10-15 |