| NPI | 1346217882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: TN 18170) |
| Additional Taxonomies | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: TN 18170) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2016-10-17 |