| NPI | 1255423133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: PA MD421338) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: PA DS042083) |
| 208200000X Plastic Surgery (Licence: DE C10006689) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: DE C10006689) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2021-09-30 |