| NPI | 1336279587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ ma29961) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NJ ma29961) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NJ ma29961) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NJ ma29961) | |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2010-03-08 |