NPI | 1134133945 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NJ 25MA06867200) |
Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NJ 25MA06867200) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2013-02-15 |