| NPI | 1952485179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: NV 1308) |
| Additional Taxonomies | 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NV 1308) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2019-11-01 |