| NPI | 1265460604 |
|---|---|
| Former Name | ALEXANDER SRAGOVICH |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 25MA07491000) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NY 227114) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2022-11-12 |