| NPI | 1750581120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME120346) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OH 57.012907) |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MN 106798) | |
| 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: MN 56834) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME120346) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2017-04-14 |