NPI | 1912090291 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: OH 35065469) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: OH 35.065469) |
Enumeration Date | 2006-10-01 |
Last Update Date | 2011-10-17 |