| NPI | 1598775884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: NY 158057) |
| Additional Taxonomies | 2082S0105X Plastic Surgery Surgery of the Hand (Licence: NY 158057) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2011-08-02 |