| NPI | 1780743518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NY 188307) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CT 0404243) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: NY 188307) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: CT 0404243) | |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2007-07-09 |