| NPI | 1871559336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 036-0986794) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: GA 37714) |
| 207W00000X Ophthalmology (Licence: FL ME0067701) | |
| 207W00000X Ophthalmology (Licence: AL 181150) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: IL 03-6096794) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL 37714) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: FL ME0067701) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: AL 181150) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2014-07-22 |