| NPI | 1730292236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: VA 0101259658) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: NC 9901624) |
| 208200000X Plastic Surgery (Licence: NC 9901624) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NC 9901624) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2022-08-15 |