| NPI | 1235239328 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NJ MA72027) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NJ MA72027) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2007-07-08 |