| NPI | 1538656467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 337138) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 337138) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2025-09-25 |