| NPI | 1508930678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: NJ 25MA07315300) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 25MA07315300) |
| 208200000X Plastic Surgery (Licence: NJ 25MA07315300) | |
| 2086S0105X Surgery Surgery of the Hand (Licence: NJ 25MA07315300) | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: NJ 25MA07315300) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2007-09-07 |