| NPI | 1407956816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NJ 25MA11709700) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME165899) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A66518) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2026-06-02 |