| NPI | 1427355825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANOJ THAKKER Owner 802-310-0664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: NJ 25MA08829200) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: NJ 25MA08673200) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NJ 25MA08673200) | |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2011-02-21 |