| NPI | 1437290392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: GA 59595) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME 104057) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: FL ME 104057) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL ME 104057) | |
| 207P00000X Emergency Medicine (Licence: FL ME 104057) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME 104057) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: GA 59595) | |
| 207P00000X Emergency Medicine (Licence: GA 59595) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2016-10-06 |