| NPI | 1356451306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME33725) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME33725) |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery (Licence: FL ME33725) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL ME33725) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2023-08-22 |