| NPI | 1083687529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CT 048790) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: CT 048790) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CT 048790) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 10263) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CT 048790) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2024-04-03 |