| NPI | 1841329216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: NM 77 154) |
| Additional Taxonomies | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: NM 77-154) |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: NM 77-154) | |
| 207YX0007X Otolaryngology Plastic Surgery within the Head & Neck (Licence: NM 77-154) | |
| 207YX0905X Otolaryngology Otolaryngology/Facial Plastic Surgery (Licence: NM 77-154) | |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2007-07-08 |