| NPI | 1730124256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NJ 25MA08686600) |
| Additional Taxonomies | 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NJ 25MA08686600) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2018-09-12 |