| NPI | 1578558557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL ME92891) |
| Additional Taxonomies | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: FL ME92891) |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: FL ME92891) | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2010-08-20 |