| NPI | 1609941244 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2086S0105X Surgery, Surgery of the Hand (Licence: FL ME0060467) | 
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME0060467) | 
| Enumeration Date | 2006-11-21 | 
| Last Update Date | 2018-09-07 |