| NPI | 1255549101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: LA MD201036) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: LA 201036) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2016-12-02 |