| NPI | 1215226311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CA A166437) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CO DR.0066342) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: CA A166437) | |
| 208600000X Surgery (Licence: NY 000000) | |
| Enumeration Date | 2011-03-30 |
| Last Update Date | 2024-05-16 |