| NPI | 1124094917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 218544) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 218544) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2010-01-26 |