| NPI | 1831352871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: NJ 25MA08436800) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: PA MD446804) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2023-07-18 |