| NPI | 1730373580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX N2616) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TX 31800) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 61000) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: FL ME108072) | |
| 204E00000X Oral & Maxillofacial Surgery (Licence: CA A118760) | |
| 208200000X Plastic Surgery (Licence: FL ME108072) | |
| 208200000X Plastic Surgery (Licence: CA A118760) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX N2616) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME108072) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA A118760) | |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2023-01-26 |