| NPI | 1407029887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD433800) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 257104) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NY 257104) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 257104) | |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2016-05-10 |