| NPI | 1124466966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID Z EVDOKIMOW President 908-221-1136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Additional Taxonomies | 207ND0900X Dermatology Dermatopathology |
| 207NS0135X Dermatology Procedural Dermatology | |
| 208600000X Surgery | |
| 2086S0105X Surgery Surgery of the Hand | |
| 2086S0120X Surgery Pediatric Surgery | |
| 208D00000X General Practice | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2013-06-13 |