| NPI | 1821121237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: FL ME85585) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: FL ME85585) |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL ME85585) | |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: FL ME85585) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2010-08-17 |