NPI | 1629157003 |
---|---|
Professional Name | TODD M WIDER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 193602) |
Enumeration Date | 2006-11-04 |
Last Update Date | 2009-02-18 |