| NPI | 1649657214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: TX U1289) |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX U1289) |
| Enumeration Date | 2015-05-02 |
| Last Update Date | 2025-08-29 |