| NPI | 1427403278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OH 35.137555) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: TN 58937) |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TN 58937) | |
| 208200000X Plastic Surgery (Licence: TN 58937) | |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2025-12-01 |