| NPI | 1114924487 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ MA71305) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NJ MA71305) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2008-01-30 |