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 |