| NPI | 1982109336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: MA 1024327) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: MN 65993) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2026-03-11 |