| NPI | 1932280559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA337) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: ME ME337) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-07-29 |