| NPI | 1346342920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MO 105827) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MO 105827) |
| 1223G0001X Dentist General Practice (Licence: MO 014805) | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MO 014805) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: MO 105827) | |
| 2082S0105X Plastic Surgery Surgery of the Hand (Licence: MO 105827) | |
| 208200000X Plastic Surgery (Licence: IL 036086950) | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: MO 105827) | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: MO 105827) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2018-02-22 |