| NPI | 1417986738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 168623) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NY 168623) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 168623) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2023-07-05 |