| NPI | 1245784636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME 129303) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: FL ME 129303) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME 129303) | |
| Enumeration Date | 2016-08-15 |
| Last Update Date | 2017-04-26 |