| NPI | 1548425937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME14463) |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: FL ME14463) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2013-04-09 |