| NPI | 1639436199 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: LA 207182) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: LA 207182) |
| 208600000X Surgery (Licence: LA 207182) | |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2025-01-29 |