| NPI | 1154398451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MI 4301042505) |
| Additional Taxonomies | 207Y00000X Otolaryngology (Licence: MI 4301042505) |
| 208600000X Surgery (Licence: MI 4301042505) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MA 38151) | |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2021-04-23 |