| NPI | 1245428663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: VA 0101254386) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: GA 64331) |
| 208200000X Plastic Surgery (Licence: CA 52988) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: VA 0101254386) | |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2018-03-17 |