| NPI | 1235266677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: ME MD20009) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-228993) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NH 17368) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MA 242158) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-03-02 |