| NPI | 1467809954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: MO 2023031311) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: KS 04-48201) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2026-06-02 |