| NPI | 1821066192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: AZ 75433) |
| Additional Taxonomies | 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: TN 51418) |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TN 51418) | |
| 208200000X Plastic Surgery (Licence: TN 51418) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: IL 036-114808) | |
| 2082S0105X Plastic Surgery, Surgery of the Hand (Licence: IL 036-114808) | |
| 208200000X Plastic Surgery (Licence: IL 036-114808) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2025-10-24 |