| NPI | 1861699506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX P4722) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 269241) |
| 208600000X Surgery (Licence: NE 5159) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 269241) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 269241) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2022-08-25 |