| NPI | 1922062116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX g4061) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: TX g4061) |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck (Licence: TX g4061) | |
| 2082S0099X Plastic Surgery, Plastic Surgery Within the Head and Neck (Licence: TX g4061) | |
| 2086S0120X Surgery, Pediatric Surgery (Licence: TX g4061) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2011-12-02 |