| NPI | 1376376780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA CRUZ Credentialing Manager 732-333-8720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2024-08-21 |
| Last Update Date | 2024-08-21 |