| NPI | 1841372968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME123837) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME123837) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2022-01-18 |