| NPI | 1316958945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: AZ 59440) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NY 175407) |
| 208200000X Plastic Surgery (Licence: NY 175407) | |
| 208200000X Plastic Surgery (Licence: AZ 59440) | |
| 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: NY 175407) | |
| 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: AZ 59440) | |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: NY 175407) | |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: AZ 59440) | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: NY 175407) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2019-11-07 |