| NPI | 1639121528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 219198) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 219198) |
| 208200000X Plastic Surgery (Licence: NY 219198) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2016-07-24 |