| NPI | 1851366090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: FL ME50427) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME50427) |
| 208200000X Plastic Surgery (Licence: FL ME50427) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2016-01-25 |