NPI | 1780840173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NJ 25MA10040600) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MD D0071793) |
2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: LA 3365355) | |
2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD465603) | |
Enumeration Date | 2008-08-05 |
Last Update Date | 2023-08-01 |