| NPI | 1760565865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: DC MD19687) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: MD D37723) |
| 2086S0105X Surgery, Surgery of the Hand (Licence: VA 0101043132) | |
| 2086S0105X Surgery, Surgery of the Hand (Licence: DC MD19687) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MD D37723) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: VA 0101043132) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2025-09-11 |