| NPI | 1780708909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME115543) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: FL ME 115543) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2022-07-21 |