| NPI | 1932376514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: CA A132714) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: CA A132714) |
| 207N00000X Dermatology (Licence: CA A132714) | |
| 207ND0101X Dermatology MOHS-Micrographic Surgery (Licence: CA A132714) | |
| 207NS0135X Dermatology Procedural Dermatology (Licence: CA A132714) | |
| 207WX0200X Ophthalmology Ophthalmic Plastic and Reconstructive Surgery (Licence: CA A132714) | |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: WA MD60365940) | |
| 207YS0123X Otolaryngology Facial Plastic Surgery (Licence: CA A132714) | |
| 208200000X Plastic Surgery (Licence: CA A132714) | |
| 2082S0099X Plastic Surgery Plastic Surgery Within the Head and Neck (Licence: WA MD60365940) | |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2023-04-19 |