| NPI | 1881695195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CO 41043) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CO 41043) |
| 208200000X Plastic Surgery (Licence: CA C202102) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2025-07-31 |