| NPI | 1669458964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 155319) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: NY 150606) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2013-12-05 |