| NPI | 1427419456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ 25MB13267300) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NJ 25MB13267300) |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2026-09-11 |