| 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 |