| NPI | 1326373812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NJ 25MA09394000) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD437321) |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2024-03-29 |