| NPI | 1891025730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NJ 25MA09112300) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: PA MD433595) |
| Enumeration Date | 2009-12-27 |
| Last Update Date | 2024-03-29 |