| NPI | 1710062336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA G39915) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CA G39915) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2025-09-11 |