| NPI | 1528086196 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL ME73172) |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: FL ME73172) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2009-02-27 |