| NPI | 1821298589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0105X Surgery Surgery of the Hand (Licence: SC 35075) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL TRN7995) |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL ME101855) | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: SC 35075) | |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2023-04-21 |