| NPI | 1467640565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NJ 25MA09735900) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD432539) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA 273296) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: DE C1-0025591) | |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2023-09-13 |