| NPI | 1861448318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME59792) |
| Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: FL ME59792) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2023-11-03 |