NPI | 1629390109 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2086X0206X Surgery, Surgical Oncology (Licence: FL ME158070) |
Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: FL ME158070) |
207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: FL ME158070) | |
204E00000X Oral & Maxillofacial Surgery (Licence: FL ME158070) | |
2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL ME158070) | |
Enumeration Date | 2010-02-24 |
Last Update Date | 2025-09-29 |