| NPI | 1326426321 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: UT 12803673-1205) | 
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: UT 12803673-1205) | 
| Enumeration Date | 2015-05-11 | 
| Last Update Date | 2022-10-20 |