| NPI | 1336438704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME121445) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME121445) |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2025-01-06 |