| NPI | 1790944478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MD D78307) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MD D78307) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2024-01-09 |