| NPI | 1881640639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL OS9566) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL OS9566) |
| 174400000X Specialist (Licence: ME LT06104) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2014-02-21 |