| NPI | 1831113257 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A95159)  | 
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CA A95159)  | 
| Enumeration Date | 2006-07-27 | 
| Last Update Date | 2025-02-19 |