| NPI | 1558561217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME101770) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: FL ME101770) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2021-03-31 |