| NPI | 1770822892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: VA 0101277580) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: VA 0101277580) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MD D0097962) | |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2024-10-17 |